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New Delhi: The Delhi government’s decision to not impose a complete ban on gatherings and allow up to 50 people to meet for political, social, cultural and other events, while completely exempting weddings from the restriction, has not gone down well with medical practitioners who believe that COVID-19 is in the second stage of spreading and thus social distancing and self-isolation of those showing symptoms of the disease are paramount.

Weddings have apparently been exempted since they are planned in advance and bookings are made in large banquet halls, hotels and wedding grounds. Putting a limit of 50 guests would have led to harassment of families and organisers by police and civil authorities. Therefore, while making the announcement for restrictions on gatherings, Delhi chief minister Arvind Kejriwal urged those organising weddings to avoid them if possible.

A senior doctor working in the field of public health for the Delhi government said that the restrictions were necessary. “This virus can survive on a surface for several days, whereas normally other viruses do not survive on inanimate objects. Therefore it can spread rapidly as it is not possible to sanitise all surfaces which are infected by the carriers,” he said.

Gatherings in small halls are risky

On the government’s decision to limit gatherings to just 50 people and exempt weddings from the restrictions, the doctor said ideally, even small gatherings should be avoided. “If 50-60 people are present in a small hall, then there would be less interpersonal space between them and the chances of the virus spreading will be higher,” he said.

When asked whether wearing any mask would help, he said, “It is just that we should not touch the outer surface of the mask and dispose of it in a closed bin.”

“Avoid these gatherings, but if you have to go, then follow some precautions,” he said. “The moment you reach the venue of a gathering, either sanitise your hand with a hand sanitizer that has at least 70% by volume isopropyl alcohol, or wash them thoroughly with soap and water. If you can’t buy hand sanitizer, spirit that is used for giving injections also contains isopropyl alcohol.”

‘Avoid salads, curd, raw paneer, leafy vegetables’

“At the venue,” he said, “avoid touching any objects. Also do not eat anything raw like salads, curd, raw leafy vegetables in any form, uncooked paneer and cold salads. The caterers should ensure optimum hygiene in the preparation and serving of food.”

Ideally, the doctor added, the caterers should also provide staff to serve people with food so that everyone does not touch the ladles. “And if this facility is not there, people should use a wet wipe or napkin to take servings from the bowls and then discard them.”

A man wearing a face mask as a precaution against the spread of coronavirus, stands in a train at a railway station in New Delhi, India, March 16, 2020. Photo: Reuters/Adnan Abidi

He also said that all gatherings should provide hand sanitizer at the entrance and only allow guests to enter after using them.

The doctor added that in Delhi, the presence of swine flu or H1N1 cases currently also posed a major risk. “So personal hygiene and the wearing of masks in crowded places will help.”

As for the N-95 mask, the doctor said that the mask should ideally not be worn for over 7-8 hours as reusing a mask poses its own set of risks and the exterior could get infected. But the mask does protect one from coming in direct contact with droplets from sneeze and cough of an infected person.

The public health expert said people showing symptoms of coronavirus infection should avoid going to any gatherings. “Symptoms of COVID-19 include dry cough and harsh breathing. A running nose is not one of its symptoms. So people who have such symptoms should avoid going to any gatherings.”

“If it is an absolute must, they should cover their own face with a three-layered mask. Else, while sneezing or coughing they should cover their nose and mouth with either a handkerchief or with the upper portion of their arms.”

The chief medical officer of a Central government facility said “there may be only isolated cases of infections just now, but we do not know the number of asymptomatic cases and if they have further spread the disease.”

So, he said, “The best way to avoid this virus is through social distancing. There is no vaccination or treatment and therefore surveillance of possible cases is the other important element.”

‘Do not touch your face’

The doctor advised some more precautions. He said that at social gatherings, and even otherwise, people should make it a habit to not touch their faces. “The coronavirus does not penetrate the skin but it can penetrate the mucous membranes present in the nose, eyes and mouth,” he said.

He advised against wearing ties or regularly getting them cleaned and urged people to clean their mobile phones regularly and sanitise their hands after touching currency notes. “The Department of Personnel and Training has closed biometrics, but what about the use of ATM machines, as the buttons are pressed by so many people. So hand hygiene is paramount.”

People with symptoms should self-isolate

He said that it is essential for people who show signs of the virus to self-isolate and not go to any major gatherings. “A test for COVID-19 requires nearly three days, including the time for paperwork. Through social isolation and distancing, we can reduce the probability of its spread.”

“What is not known right now is if an asymptomatic patient can spread it. This is an important aspect because, in measles, people are known to start transmitting three days before the first rash comes and, in chickenpox, five days prior to the emergence of skin lesions.”

Right now, he said, COVID-19 is in the second stage. “In the first, it comes, in the second it starts spreading. We need to watch out to see if many more people get infected after coming in contact with both the symptomatic and asymptomatic patients,” the doctor said.